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Asthma Attack

An asthma attack happens suddenly. You may notice worsening symptoms in the hours or days before your child has an attack. That is why it is very important to know what is normal for your child's asthma. Then you will be able to spot when they are unwell and what you need to do. You could keep a symptom diary.

 

If your child’s asthma suddenly gets worse (asthma attack), they will need urgent treatment.

Signs of an asthma attack include:

  • Sounding very wheezy

  • Having a tight chest

  • Finding it hard to breathe

  • Being too breathless to talk or walk 

Sometimes there is no obvious cause for your child’s asthma attack. The most common triggers are viral infections (coughs, colds and chest infections), emotional anxiety and exposure to airway irritants such as cigarette smoke.

 

What should I do if my child is having an asthma attack?

1. Sit your child upright

2. Keep them calm and reassure them

3. Refer to your child’s action plan and follow the instructions

What should I do?

If your child has any of the following:

  • Not improving despite using their inhaler according to their action plan

  • Breathing very fast, too breathless to talk, eat or drink 

  • Working hard to breathe, drawing in of the muscles below the ribs, or noisy breathing (grunting)

  • Breathing that stops or pauses

  • A harsh noise as they breathe in (stridor) present all of the time (even when they are not upset)

  • Is pale, blue, mottled or feels unusually cold to touch

  • Difficult to wake up, very sleepy or confused

  • Has a fit (seizure)

  • Has a rash that does not go away with pressure (the ‘Glass Test’)

You need urgent help

Go to the nearest Hospital (A&E) Emergency Department or phone 999

Keep your child upright and reassure them

Get your child’s inhaler and follow your action plan

If your child has any of the following:

  • They need increased doses of their inhaler for more than 2 to 3 days

  • Breathing a bit faster than normal or working a bit harder to breathe

  • A harsh noise as they breathe in (stridor) only when upset

  • Dry skin, lips or tongue

  • Not had a wee in last 8 hours

  • Temperature of 38°C or above for more than 5 days or shivering with fever (rigors)

  • Temperature less than 36°C in those over 3 months

  • Getting worse or you are still worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or NHS 111 – dial 111

Continue to follow your child’s action plan while seeking advice.

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features

If none of the above features are present

Watch them closely for any change and look out for any red or amber symptoms

Continue to follow your child’s action plan while seeking advice 

If your child has other symptoms associated with their asthma attack, you might want to look at our information on sore throat, cough, earache, diarrhoea and vomiting or tummy ache or our other pages.

Give 2 to 4 puffs of blue (salbutamol) reliever inhaler every 4 hours until symptoms improve

Make an appointment with your GP or asthma nurse within 24 hours

This guidance has been reviewed and adapted by healthcare professionals across West Yorkshire with consent from the Hampshire development groups.

Asthma attack prevention

The most common triggers are viral infections (coughs, colds and chest infections), exposure to pets, pollen, sudden changes in the weather and exposure to cigarette smoke. Sometimes there is no obvious cause for your child’s asthma attack.

Things you can do to reduce the chance of your child having an asthma attack:

1. Get your child’s asthma under control

Children with poorly controlled asthma are much more likely to have an asthma attack compared to children whose asthma is well controlled. Make sure your child takes their preventer inhaler regularly as prescribed.

Signs of poorly controlled asthma:

  • A regular cough at night (nocturnal cough)
  • Wheezy or more breathless than other children when they run around
  • Using their blue reliever inhaler more often than expected, for example more than twice a week

If your child has any signs of poorly controlled asthma they need a review. Make an appointment with their GP or asthma nurse. 

It is important to have a yearly asthma review with your asthma nurse or GP. Your child is 4 times less likely to end up in hospital with an asthma attack if they have a personal asthma action plan .

 

2. Get the inhaler technique right

Watch these Asthma UK videos on how to help your child use their inhalers effectively.

It is vital that your child uses their inhalers and spacer correctly. 

Your child’s asthma will not be controlled if their medicines are not getting into their lungs.

Use an appropriate sized spacer with a mask. A spacer with a mouthpiece can be used if your child is over 3 years old, has a good technique and is not very short of breath.

1. Shake the inhaler well and remove cap

2. Fit the inhaler into the opening at the end of the spacer

3. Place mask over the child's face or mouthpiece in their mouth ensuring a good seal

4. Press the inhaler once and allow the child to take 5 slow breaths

5. Remove the inhaler and shake between every puff

Repeat steps 1 to 5 for each dose

Plastic spacers should be washed before the first use and every month as per manufacturer's guidelines.

See your practice nurse or doctor if you are not sure whether your child is using their inhaler and spacer properly.

 
3. Avoid triggers where possible

Although it is extremely difficult to avoid your child getting a viral infection or experiencing changes in the weather, you can reduce exposure to common triggers such as pets, pollen and cigarette smoke.

Even when adults smoke away from their children, smoke on their clothes and hair can make their child’s asthma worse.

Visit the Healthier Together page on how to stop smoking.

 

4. Your child should have an influenza immunisation every autumn (the flu jab)

Not only can flu trigger an asthma attack in your child, your child is more likely to experience severe influenza if they have asthma. Protect them by having them vaccinated every year.

For more information about the flu jab see our childhood immunisations page.

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Where should you seek help?

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

All community pharmacies across England are required to be Healthy Living Pharmacies. This means that they are able to offer advice on a range of healthy living matters which includes eating a healthy diet. They can provide information leaflets and give parents, carers and young people more information about other organisations that might also be able to help.

Pharmacists are experts in many aspects of healthcare, and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment, and many have private consultation areas. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand. Watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns, or to the Community Paediatricians, or the child and adolescent mental health services.

 

Contact your local Health Visiting Team:

Bradford Health Visitors or call - 01274 221223

Wakefield Health Visitors or call - 0300 373 0944

Craven Health Visitors or call - 01423 544265

Leeds Health Visitors or call - 0113 843 5683

Calderdale Health Visitors or call - 030 0304 5555 (local rate number)

Kirklees Health Visitors or call - 030 0304 5555 (local rate number)

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

For more information about what Health Visitors do: What does a health visitor do?

School nurses care for children and young people, aged 5 to19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and, or emotional health needs.

 

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse. Phone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Contact your local school nursing team:

Bradford School Nurses 01274 221203

Wakefield School Nurses (0 to 19 service) 0300 373 0944 (local rate number)

Leeds School Nurses 0113 843 5683

Calderdale School Nurses 030 3330 9974 (local rate number)

Kirklees School Nurses 0300 304 5555 (local rate number)

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

All children should be registered with a GP. Anyone in England can register for free with a GP surgery. You do not need proof of address or immigration status, ID or an NHS number.

How to find your local GP.

Sound advice

You have a choice of service:

  1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.
  2. Help your child to understand. Watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Please note, the online version of NHS 111 is only recommended for children over the age of 5. If your child is under 5 years old, please phone 111.

NHS 111 can also direct you to your nearest urgent treatment centre (minor injuries unit or walk-in centre).

Find your local urgent treatment centre.

When to visit an urgent treatment centre.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as:

  • loss of consciousness
  • breathing difficulties
  • severe bleeding that cannot be stopped
  • major trauma such as road traffic collisions

If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand. Watch this video with them about going to A&E or riding in an ambulance